内镜下冲洗术对单纯性结肠憩室炎诊治价值的研究(附4例报告)  

Diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis(4 cases)

作　　者：孙传涛 朱晓文 单宝珍 李德平 杨帆 刘晓波 Sun Chuantao;Zhu Xiaowen;Shan Baozhen;Li Deping;Yang Fan;Liu Xiaobo(Department of Gastroenterology,the Second Affiliated Hospital,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310005,China;Department of Gastroenterology,Taihe Hospital(the Affiliated Hospital of Hubei University of Medicine),Shiyan,Hubei 442008,China)

机构地区：[1]浙江中医药大学附属第二医院消化内科,浙江杭州310005 [2]十堰市太和医院(湖北医药学院附属医院)消化内科,湖北十堰442008

出　　处：《中国内镜杂志》2024年第6期37-42,共6页China Journal of Endoscopy

摘　　要：目的探讨内镜下冲洗术对单纯性结肠憩室炎的诊断与治疗价值。方法选取2021年6月-2022年3月于该院就诊,拟诊为单纯性结肠憩室炎,行结肠镜检查的患者4例,术中确诊为结肠憩室炎后,行内镜下冲洗治疗。总结结肠憩室炎内镜下表现,比较治疗前后腹痛症状、白细胞(WBC)和C反应蛋白(CRP)的变化,观察住院时间和预后。结果4例患者中,2例确诊为急性升结肠憩室炎,2例确诊为急性盲肠憩室炎,内镜下可见炎症憩室开口周围黏膜充血水肿糜烂,憩室开口可见脓性分泌物、脓苔和粪石。经内镜下冲洗治疗后,患者腹痛症状减轻,WBC和CRP较治疗前降低;住院3~5 d后,痊愈出院。结论内镜下冲洗术对单纯性结肠憩室炎有较高的诊断与治疗价值,具有微创、安全和高效等特点,值得临床进一步研究探讨。Objective To study the diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis.Methods From June 2021 to March 2022,4 patients suspected uncomplicated acute colonic diverticulitis who then underwent colonoscopy,and endoscopic irrigation treatment was performed after confirming.The endoscopic imaging of acute colonic diverticulitis was summarized.The changes of abdominal pain symptoms and prognosis of the patients were evaluated.The levels of white blood cell(WBC)and C-reactive protein(CRP)in serum before and after treatment were measured.Results 4 patients were diagnosed as uncomplicated acute colonic diverticulitis underwent colonoscopy.Two cases were located in the ascending colon and the other two in the cecum.Endoscopic imaging characteristics included mucosal hyperemia and swelling of diverticular orifice and nearby area,purulent secretions,purulent fur and fecalith at the diverticular orifice.After treatment,the symptom of abdominal pain was relieved,the levels of WBC and CRP in serum were lower than before treatment.Conclusion Endoscopic irrigation has a useful diagnostic and therapeutic value for uncomplicated acute diverticulitis of the colon.It is worthy of further clinical study.

关 键 词：结肠憩室炎 结肠镜检查 内镜治疗 诊断 

分 类 号：R574.62[医药卫生—消化系统]